Eyelid ptosis surgery is usually performed as a day case and will not require an overnight stay. For children, the operation is performed under general anaesthetic.
The oculoplastic surgeon makes a few very small incisions in the eyelid and over the brow, and then passes the suspension material through the incisions to join the eyelid with the forehead. The small incisions are closed with discrete stitches.
Under general anaesthetic no pain will be felt. After the operation they will feel a little discomfort around the eye but this usually settles within a few days.
The operation can also be done under local anaesthetic where just the forehead or eyelids are injected and are pain-free.
The oculoplastic surgeon does not usually pad the eye after a frontalis suspension as the eye stays open and the pad could scratch the eye.
At the end of the operation the oculoplastic surgeon puts a lot of antibiotic ointment on the eye to protect it. Post-operative care consist of applying antibiotic ointment to the eye and wound 3 or 4 times a day and painkillers for any pain or discomfort.
Initially the eyelids are often bruised and swollen. The bruising can take 2-3 weeks to clear and there may be some residual swelling for up to 6 weeks.
It often takes several months for the lids to settle into their new position, and only then can the effectiveness of the surgery be assessed. The scars will fade gradually, but in any case are very small and tend to be hidden within the crease of the eyelid.
One risk of a frontalis suspension is asymmetry between each side requiring further operations, sometimes a few years later.
Other, rarer complications can include:
- Infection of the material (if this happens the surgeon makes an operation to remove the infected material)
- Extrusion of the material (sometimes another operation is needed to remove/replace the material)
- Difficulties in closing the eye properly. This is helped by lubricant eye drops and only very rarely is a further operation required.